and such service was completed on ______ . I further certify that the amount of
___ is due for such service, and this amount is true, correct and unpaid.
Signature.
CERTIFICATION OF SERVICES RENDERED
Date: _____________________
I
_____________________________ do hereby certify that the following service,
________________________________________________________________________ and such service was completed on _____________ . I further certify that the amount of
___
is due for such service, and this amount is true, correct and unpaid.